The authors describe the case of a 46-year-old male presented with repeated massive gastrointestinal haemorrhage as the first clinical symptom of jejunal metastasis of a malignant tumour. Orchiectomy of the enlarged testis was subsequently carried out and testicular seminoma was found on histology. Metastases of seminoma to the liver and lung were detected. The source of gastrointestinal bleeding was identified by means of capsule endoscopy. Push enteroscopy was performed subsequently. At the present time, capsule endoscopy is a non-invasive method capable of visualizing a substantial part of small intestinal mucosa within a major part or even the whole small bowel. Push enteroscopy allows to see nearly all mucosal surface but only within the upper part of the small intestine, i.e. duodenum and the proximal part of the jejunum (up to 60 to 120 cm away from the Treitz ligament). As the tumour of our case was generalised when diagnosed and could not be treated either endoscopically or surgically, a cisplatinum based chemotherapy was started (bleomycin, etoposide, cisplatinum). Evident regression of the pulmonary and liver metastases was achieved according to control CT scan and there was no further gastrointestinal bleeding during the subsequent nine-month follow-up.

Clinical centre 2nd Department of Internal Medicine Charles University Teaching Hospital Hradec Králové

Metastáza testikulárního seminomu do jejuna se závažným gastrointestinálním krvácením diagnostikovaná pomocí kapslové endoskopie

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